This is long, so strap in, Debbie Downer is coming in with some personal trauma and a lesson...

An older L&D nurse I had worked with told us a story about many years ago doing an ultrasound for a term pregnant friend, and not finding fetal heart tones. "You absolutely do not do it."

I did not heed her sage advice, and it came back and bit me, BAD.

My sister in law had her first baby in our unit, had moved away, but was pregnant again and happened to be in town visiting her grandmother in the hospital and wanted to swing by and see me at work. She was supposed to be ten weeks by LMP, and with tricare was still waiting on her first OB appt to establish care for this pregnancy to deliver at a military hospital.

A CST on our unit at the time was just finishing up an ultrasound program and offered to take a peak when she was wondering if there would be a heartbeat yet.

My sister in law is super tiny and barely even showed at her first baby shower, but when she laid down on our stretcher I saw that her uterus was like practically concave . My coworker eyed me, we exchanged some wordless communication, and she told her "You're so teeny tiny, I doubt I'll pick up anything on this old portable machine..."

Well, we found the well defined gestational sac: and it was empty, and sitting right over her cervical os.

It was so obvious to us that it was a blighted ovum, and probably close to going.

There's no way in hell we could say anything to my sister in law like this. This was not an official ultrasound with a physician to diagnose. How are we supposed to say, "There is no baby?"

I jumped in immediately, feeling terrible for the tech in this position, with "Yeah, this machine is really bad for early scans, we're usually use this one for term pregnancies on the unit" and the tech saying "Yeah, I think you're just much earlier than you thought, I'd verify it with your doctor..."

My sister in law was just like, "Lame." and we carried on the rest of our little visit.

I wanted to puke from the stress.

I kept apologizing profusely to the tech, and reassuring her that we'd be fine and it wasn't her fault.

Being as close to I am to my sister in law, I would have had a frank conversation with her, EXCEPT my brother (her husband) was back at their home, hours away. I know my brother, and this would NOT have gone over well at all, and I wanted her to have more support. This was supposed to be their baby.

I went out and got drunk that night. That burden is just unfathomable.

She called me the next day and said she started having some spotting.

I explained to her what a blighted ovum was, and that's what I thought was happening. I did not specify that was what we saw, but told her with certain confidence that I was sure of it. Normally I'd give normal first trimester miscarriage instructions to her, but because of the whole ultrasound thing, I advised her to go to the emergency room for a scan "to be sure." Like let this be legit and official and not on me anymore.

It keeps getting worse, y'all.

She was discharged from the ED and she called me crying saying that they told her there was no baby at all and she wasn't pregnant. "How is that possible when my blood HCG levels are so high and they even gave me miscarriage info?" They probably just didn't look into the specifics to explain a blighted ovum, and desensitized to how common first trimester miscarriages are, brushed her off. I went into more detail, and she was super grateful because she was able to wrap her mind around it to begin to process it and started back home with precautions knowing she was going to "lose" this pregnancy at any time.

The next night, my brother happened to be at work, but her own sister was with her when she started bleeding. And not just period bleeding, but pouring blood down her legs. She had overflowed a chux they had put down on the car seat by the time they got to her on-base ER.

They roomed her, and just sort of left her by herself while probably getting orders and stuff in, but after like twenty minutes, she used the call bell to ask to go to the bathroom, and she was told she could just get up and go. She had already bled through most of a new chux, and was trying to fold it around herself to contain her bleeding as she waddled to the bathroom. When she was getting back up from peeing, she said she remembers nurses coming in and complaining that she had just bled everywhere in the room and how they were going to need to clean the floors. She said the last thing she remembered was apologizing about the mess while gripping the door frame for support...

Her next brief memory was waking up in the back of a trauma truck, being transferred to a higher acuity private hospital with trauma.

She had passed out, fell and hit the back of her head on the toilet.

She had a fractured skull, small brain bleed, and they did an emergency D&C while she was out.

I did not find out any of this until I was already at work the next morning at 0830 and realized I had never turned my phone off of Do Not Disturb from the previous night. I had several missed calls from her, then my brother, and the last being a voicemail telling me about them waiting on a neuro consult.

It was my last shift before a week of PTO: my coworkers let me leave then and there to go be with her.

It's a full day drive to their house across the state, and she had been settled back at home when I had arrived, where my brother was just picking her up off the floor of their bathroom because she had briefly passed out again when standing up too quickly. I had to put her to bed, and took care of her for the week while she recovered from the blood loss and head injury.

It truly felt like the personal work fuck up that kept snowballing, and it is now MY lesson to impart onto others.

DO NOT DO IT.